The document discusses post-abortion care, emphasizing its importance in women's health initiatives since the 1990s and the need for comprehensive services. It details the essential elements of post-abortion care, including community partnerships, counseling, treatment, family planning services, and reproductive health services aimed at reducing morbidity and mortality from incomplete abortions. The document stresses the necessity of accessible, quality care across all service levels to support women post-abortion and prevent complications.

1. POSTABORTION CARE
MR MULUNDANO
BSC-NS UNZA

2. INTRODUCTION
• The term "post abortion care" was
first articulated as a critical
element of women's health
initiatives in the early 1990s, and
the message was to integrate in
the developing world.

3. INTRODUCTION
• Under the same period post
abortion family planning and other
reproductive health care as
essential elements were listed as
a framework for providing quality
abortion care.

4. INTRODUCTION
• In the same period a model was
developed which comprised of three
elements: emergency treatment
services for complications of
spontaneous or unsafely induced
abortion; post abortion family planning
counseling and services; and links
between emergency abortion
treatment services and comprehensive
reproductive health care.

5. INTRODUCTION
• The concept of post abortion care
provides the basis for reducing
mortality and morbidity from
incomplete abortion, whether
spontaneous or induced.

6. INTRODUCTION
CONT’D
• In order to reduce the risk of long
term illness or disability, and
death, to women presenting with
the complications of incomplete
abortion, health care systems
must provide easily accessible,
quality post abortion care at all
service levels

7. INTRODUCTION
CONT’D
• Some time back Emergency Post
abortion care was provided mainly
in higher level district hospitals.
• This did not only lead to high cost
of providing these services but
made them inaccessible to many
women.

8. INTRODUCTION
CONT’D
• Prevention of abortion related
illness and mortality is dependent
on the availability of emergency
post abortion care throughout
the health care system.

9. GENERAL OBJECTIVE
• At the end of the
discussion/lecture,the student
nurses should acquire knowledge
and skill on post-abortal care

10. SPECIFIC OBJECTIVES
1. Define post- abortal care
2. Explain the scope of the problem
3. Explain the elements of PAC
4. State the Termination of
Pregnancy ACT

11. DEFINITIONS
• Post abortion care; It is the care
given to the woman following an
abortion. This includes medical
and nursing care and is done at all
hospital levels.

12. • Counseling
• This is the process of helping and
supporting a person to resolve
personal, social, or psychological
challenges and difficulties.

13. ELEMENTS OF POST
ABORTION CARE
• Comprehensive post abortion care
services should include both medical
and preventive health care. In order to
realize this, five elements of post
abortion care were developed, that
reflects, from a provider and a
consumer perspective, an enhanced
vision of high-quality, sustainable
services.

14. ELEMENTS OF POST
ABORTION CARE cont’d
• The essential elements of
postabortal care shift the focus
from facility-based medical
treatment to a public health
approach that responds to
women's broader sexual and
reproductive health needs. The
key elements include;

15. 1. Community and service
provider partnerships
2. Counseling
3. Treatment
4. Family Planning and
Contraceptive Services
5. Reproductive and other health
services

16. 1. Community and service
provider partnerships
• At this level, Community health
education and mobilization have
been identified as key strategies
to combat unsafe abortion,
increase access to and quality of
post abortion care programs, and
improve women's reproductive
health and lives.

17. • In order to achieve this, community
leaders and advocacy groups, lay
health workers, traditional healers
and formally trained service
providers have been identified as
major key partners of nurses and
other health personnel in fulfilling
the following tasks;

18. TASKS OF THE COUMUNITY
PARTNERS.
i. Providing Education
– On contraceptive usage and thereby
help women prevent unwanted
pregnancy, space births and reduce
unsafe abortion;
– about obstetric emergencies and
appropriate care-seeking behaviours;

19. THE COUMUNITY
PARTNERS.
Figure 1: SMAG providing IEC to community members in
Chitambo

20. THE COUMUNITY
PARTNERS.
Figure 2: community members and guidance of NHCs
working together in the construction of an outreach heath
post, to allow easy provision of FP in Chitambo

21. THE COUMUNITY
PARTNERS.
Figure 3: outreach health post constructed by Community
partners for provision of ANC and FP services in Chitambo.

22. THE COUMUNITY
PARTNERS.
Figure 4: SMAG demanded for an audience with the DHO, to air their
views on how mother and child health services can be effectively
delivered

23. TASKS OF THE COUMUNITY
PARTNERS cont’d
ii. Participation by community
members in decisions about
availability, accessibility and
cost of services;

24. Figure 5: Bicycle ambulance for Obstetric emergencies

25. TASKS OF THE COUMUNITY
PARTNERS cont’d
iii. Mobilization of community
resources, including
transportation, to ensure that
women experiencing obstetric
emergencies receive timely
care;

26. TASKS OF THE COUMUNITY
PARTNERS cont’d
iv. Access to services for special
populations of women, including
adolescents, women with HIV or
AIDS, women who have experienced
violence or genital cutting, women
who have sex with women, refugees,
commercial sex workers, and women
with cognitive or physical disabilities;

27. TASKS OF THE COUMUNITY
PARTNERS cont’d
v. Advocacy for holistic, human
rights-based reproductive
health policies and services that
meet community expectations,
priorities and needs; and
vi. planning for sustainability.

28. 2. Counseling
• Effective counseling enhances a
woman's understanding of the
psychosocial circumstances
surrounding her reproductive past
and future, and increases her
confidence in her ability to
participate in her health care.

29. • The aims of counseling are to:
solicit and affirm women's feelings and
provide emotional support throughout
the post abortion care visit;
ensure that women receive accurate
and appropriate information about their
medical conditions, test results,
treatment and pain management
options, and follow-up care;

30. Ensure that women understand how
to prevent complications after the
procedure and that they know when
and where to seek care for
complications if they arise;

31. Help women clarify their thoughts
and decisions about pregnancy,
abortion, treatment, resumption of
ovulation and future reproductive
health; and

32. Enable providers, by listening to and
asking questions of women, to better
understand and respond to factors that
can affect a woman's health care
needs, such as experiences with
sexually transmitted infections
(including HIV), violence-induced
trauma or the effects of female genital
cutting.

33. 3. Treatment
• Treatment remains a critical part
of care, because a woman who
has had an incomplete
spontaneous or unsafely induced
abortion will, in many cases, need
uterine evacuation and other
medical intervention.

34. 4. Family Planning and
Contraceptive Services
• Women that receive post abortion
services should be given this
package in order to prevent an
unwanted pregnancy or/and space
births.

35. • For this to happen facilities' such
as contraceptive service
infrastructure must be adequate
contraceptive commodities must
be provided and providers must
be knowledgeable about which
methods are appropriate for
women following treatment.

36. 5. Reproductive and
other health services
• There should be provision of all
appropriate health services at the
time women receive post abortion
care, preferably at the same
facility.

37. • When a facility is unable to provide
needed services, it should have
functional mechanisms in place for
making referrals (either within the
facility or to another one), receiving
feedback from referral sites or
providers, and performing follow-up;
such mechanisms should include
consistent and accurate record-
keeping.

38. • The following additional services
might be offered:
• Education about the prevention of
sexually transmitted infections,
including HIV, as well as
screening, diagnosis and
treatment;

39. • Services addressing gender-
based violence, including
screening, counseling and referral;
• Infertility diagnosis, counseling
and treatment;
• Nutrition screening and education,
and treatment of nutritional
deficiencies;

40. • Hygiene education; and.
• Screening, counseling and
treatment for reproductive-related
cancers

41. POST-ABORTION CARE
• A number of issues must be
considered in providing emergency
post abortion care. Treatment may
include stabilization and referral,
oxygen, intravenous (IV) fluid
replacement, blood transfusion or
medicines (for example, antibiotics,
management of pain and tetanus
toxoid).

42. Emergency treatment
Emergency treatment for post
abortion complications includes:
• An initial assessment to confirm the
presence of abortion complications.
• The patient's hemodynamic status
must be assessed immediately,
and intravenous access obtained.

43. • Talking to the woman regarding her
medical condition and the treatment
plan

44. • The potential for blood transfusion
must be anticipated. The patient's
vital signs, the rate of bleeding,
and the overall condition must be
monitored constantly for
improvement or deterioration.

45. • Medical evaluation (brief history,
limited physical and pelvic
examinations)
• Prompt referral and transfer if the
woman requires treatment beyond
the capability of the facility where
she is seen

46. • Stabilization of emergency
conditions and treatment of any
complications (both complications
present before treatment and
complications occurring during or
after the treatment procedure)
• Uterine evacuation to remove
retained products of conception
(POC)

47. • THE END